Patients older than 80 are less likely to receive the combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) as treatment for diffuse large B-cell lymphoma (DLBCL), according to an article published online in Cancer.
Data was provided from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Characterization was complete according to presentation, treatment, and survival patterns in patients diagnosed with DLBCL between 2002 and 2009.
Of the 4,635 patients included, 1,156 (25%) were older than 80. Instead of receiving R-CHOP, the patients over 80 years were more likely to be observed or receive the combination of rituximab, cyclophosphamide, vincristine, and prednisone (P<0.0001 for both).
Through multivariable Cox proportional hazards models, the R-CHOP therapy regimen was determined to be the only regimen associated with improved overall survival (hazard ratio, 0.45; 95% confidence interval: 0.33-0.62) and lymphoma-related survival (hazard ratio, 0.58; 95% confidence interval: 0.38-0.88).
The study suggests that R-CHOP be considered as a regimen for patients older than 80 years and further studies be conducted on the correlation of treatment of DLBCL and the quality of life of these patients.
Williams, J. N., Rai, A., Lipscomb, J., Koff, J. L., Nastoupil, L. J. and Flowers, C. R. (2015), Disease characteristics, patterns of care, and survival in very elderly patients with diffuse large B-cell lymphoma. Cancer, 121: 1800-1808. doi: 10.1002/cncr.29290